Fluconazole is NOT indicated for urinary tuberculosis
Fluconazole is an antifungal medication and has no role in treating tuberculosis, which is a bacterial infection caused by Mycobacterium tuberculosis. The question appears to contain a fundamental error in medication selection.
Standard Treatment for Genitourinary Tuberculosis
Genitourinary tuberculosis should be treated with standard anti-tuberculosis drugs, not antifungal agents. The recommended regimen consists of:
Initial Intensive Phase (2 months)
Continuation Phase (4 months minimum)
Treatment Duration Considerations
The standard 6-month regimen may be insufficient in certain clinical scenarios. Extended therapy beyond 6 months should be considered for 1, 3:
- Cavitary disease
- Kidney abscess or malfunction
- HIV co-infection
- Poor nutritional status or social conditions (relapse rates up to 19% with 12-month therapy) 3
Some experts recommend continuing therapy for at least 12 months in genitourinary tuberculosis due to higher relapse rates observed with shorter courses 3.
Drug-Resistant Disease
Multi-drug resistant tuberculosis (MDR-TB) requires 18-24 months of treatment with second-line agents including 1:
- Long-term intravenous aminoglycosides (amikacin 15 mg/kg/day or kanamycin) 2
- Fluoroquinolones (levofloxacin 500-1,000 mg daily preferred) 2
- Other second-line agents based on susceptibility testing
Surgical Considerations
Complications such as urinary tract obstruction may require corticosteroids or surgical intervention in addition to medical therapy 1, 4.
Critical Clarification
If the question intended to ask about urinary tract candidiasis (fungal infection), then fluconazole would be appropriate at 50 mg daily for several weeks, achieving 71-86% clinical cure rates 5. However, this is an entirely different condition from tuberculosis.